Thursday, July 23, 2015

Our IVF Success Rate is 80%

I was speaking yesterday to a VC ( venture capitalist) who was looking at investing in a chain of IVF clinics in India , and he asked me, " What’s your success rate?" I explained that the average is about 46%, but this is a complicated question, and the answer depends on multiple variables, such as the age of the woman; how many eggs she grows;, and what the quality of the embryos is . He cut me off and said, “Oh, I spoke to an IVF doctor who says his success rate is 80% and you say that yours is only 46%, which means you can’t be a very good IVF clinic? " And he then added “I understand that realistically success rates in IVF cycles are in the range of 40% to 50% and that any doctor who claims to have a 80% pregnancy rate for all patients is obviously trying to take me for a ride - and I’m not an idiot !"

There’s a lot of medical inflation these days - and it’s not just the prices of medical treatment that are going up - it’s the tall claims which IVF doctors are making about their success rates ! They bandy figures , and there is no check or control. They can pretty much say what they like , and they don’t have to prove it one way or the other, which means patients are supposed to take their word for it.These kinds of claims cause a negative vicious cycle, because patients then start getting unrealistic expectations . It then becomes a game of one-upmanship amongst IVF clinics, who then start trying to compete with each other as to who can make the tallest claims ! They inflate their figures and manipulate their success rates.

The trouble is that when they make outlandish claims, they start becoming the object of ridicule amongst educated patients - after all, patients aren’t fools. Of course not all patients are smart enough to be able to differentiate between a doctor who is stretching the truth and, unfortunately, these are the ones who get taken for a ride.

Effectively this kind of manipulation boils down to telling the patient lies. While it’s possible to fool some of the patients some of the time, it’s not possible to fool all the patients all the time - and this kind of falsehood will come back to haunt the doctor.

It’s easy to make these tall claims because IVF clinics are selling hope. But you can’t continue living on false claims on an ongoing basis. After all , patients talk to each other, they do their homework, and they countercheck what’s happening on the net . As it is, they don’t trust doctors anymore, because we have betrayed their trust, so they take everything any doctor says with a large pinch of salt. IVF doctors should understand that their actions have consequences , and making these kind of inflated claims harms all IVF clinics - even the good ones, because patients start treating all IVF doctors as cheats and crooks.

Talk is cheap, and while it’s easy to make claims, at some point you need to deliver results. When you fail to do this, it’s going to create a lot of unhappiness and angst, which is then going to cause a backlash, which ends up hurting not just that IVF clinic who’s making those tall claims, but all IVF clinics as well.

The reason doctors continue to get away with this is because there is very poor documentation , and most patients aren’t still sophisticated enough to ask probing questions. However , doctors who make these kind of tall claims actually end up becoming a laughing stock, because their colleagues and peers have a very low opinion of them . And the market itself is quite sophisticated and knows the reality, which means IVF drug distributors, pharma companies, laboratory equipment manufacturers and even their own staff know what the truth is . At some point, Satyameva Jayate - the truth will prevail.